| NPI | 1972588119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NE 14622) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: IA 26981) |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2014-08-06 |